Historically, premium services consisted of single feeds distributed on encryptedanalog channels. Modern premium services have grown to include several "multiplex" channels and, in some cases, a video-on-demand service, and are distributed via digital means. In most cases they show movies throughout the day, with occasional original series, sports events, and other specials. Pay per view provides similar material without subscription, usually at a higher premium.

Unlike other cable networks, premium services are almost always subscribed to individually, meaning that one can, for example, subscribe to HBO without subscribing to Showtime (In Canada, there are slight modifications, as most providers include U.S. superstations with their main premium package by default). However, subscribing to an "individual" service automatically includes access to all of that service's available multiplex channels and, in some cases, access to content via video-on-demand.

Due to their high subscription fees, premium television services are generally the most profitable services in their respective territories.